bd2rn

Thank you for the reply. I'll look it over. I expect to stand by my practice of diluting just prior to administering in order to avoid "losing" the Med in the tubing and especially the connectors, but I am open to learning something new if-IF-they can convince me that my process is flawed.

Not SAFE? That's weird. What was their rationale for that statement?

It truly varies from place to place. On Med Surg, the shifts can have DIFFERENT factors that can make the shift hectic. It also depends on whether you like to have lots of people around you or if you'd rather do your own thing. Having lots of people around can be draining, IMO.

As someone who has worked for over fourty years in nursing and is also a teacher (gradeschool, MS, HS, adults,) I cannot say that there is any sort of simple answer to your question. So, here's the simplest good response I can come up with: Get the outline of what they say is on the test. Look it over carefully. If possible, take a sample test, to find out where you are. Then, make a list of things you need/wish to review. Then, choose a Goal Date for when you'd like to sign up for the test. Then make a study plan that includes reasonable, measurable, goals, including dates. Then, follow your plan. Then do another check for understanding "sample test," if possible. Revise your Study Plan or just take the test whe you feel ready. There have been times when I just bit the bullet and took an actual test as a sort of "pretest" check for understanding, only to pass the thing just fine without "studying" at ALL. Other times, I have felt a wish to learn more REGARDLESS of how I might do on a test, so I just started with the outline, checklist, etc. So, basically, take ownership of your learning needs (like you probably did in nursing school, I hope,) and pursue the goal! And do keep us posted!

. Okay, so you have not seen this. That is somewhat useful information. I actually HAVE seen it numerous times, but it's good to know that it is not as common as I feared.

You've misunderstood my question. What I am saying is that the newer pumps are allowing HUGE infiltrations that the older pumps did not allow. I am wondering why TPTB are allowing this situation.

I'm obviously not explaining my concern well. What I am finding is that the newer pumps I've come across the past several years DO NOT ALARM when there is increased pressure due to an extravasation. They just keep quietly pumping away. I hadn't seen such indurations sonde the early 1980s. By 1985, we DID have pumps that would alarm and stop when the preyis high d/t extravasation. I'm just trying to figure out why the newest pumps don't do their jobs as well as the older ones. (At this point, I'm guessing nobody here knows, either.)

No, of course the pump can't know what is causing the increased resistance, and I don't think I implied that. What I am getting at is that there are pumps that detect increased resistance and that they alarm and stop when they meet the trigger. I have cared for thousands of patients since the mid-80s, when I first used pressure-sensitive pumps. Over the last couple of years, however, I have seen enormous infiltrations-200 to 500ccs or so-that I never saw in previous decades. I'm trying to understand why these newer pumps allow that. Obviously, we need to monitor the sites frequently, as always. That's a given. I'm trying to understand why we're getting pumps that don't do their job.

The two hospitals I have worked for most recently use IV pumps (I don't remember what brand) that do NOT have pressure sensors that trigger an alarm to indicate that the infusion is infiltrating. I have seen infiltrations the likes of which I hadn't seen since the early 1980's. I was told "this happens all the time with IV pumps, and I could not convince them otherwise. I would like to hear opinions and I formation from knowledgeable nurses about this.

What Rebekulous said, above. ^

While some places do hire new grads for ICU, that doesn't mean it's a good idea. Spend a couple years on medsurg gaining knowledge and skills, and the find an internship in ICU, if you want to.

Also, I always advocate for new grads to start on Med-Surg for at LEAST a couple of years. Nothing beats that experience. Nothing. And you will take those skills you honed and that knowledge you gained with you.

Cardiac Tele is for pts who are admitted with more purely cardiac problems, and Medical Tele is pts with medical problems who also need cardiac monitoring.

Beware of ICU-it's all about drama.

Upon re-reading the OP, I find it impossible The any nurse could have been working for 12 years pouring meds and not know how to measure a liquid with a syringe. I call BS.